DCD A/N

FORM 4A

PERMISSION SLIP FOR FIELD TRIP

_________________________________________
(Facilitys Name)

_______________
(Todays Date)

_________________________has a special field trip planned and would like your

(Name of Class)
permission to take your child.
Date of Trip_________________________

Departure Time________________

Location of Trip______________________

Return Time___________________

Phone(_____)________________________ Method of Travel_______________

Driver(s) ______________________________________________________________
To give permission, please sign the lower half of the permission slip and return it to
the class by __________________________.
(Date)
(keep the top half for your information)

-----------------------------------------------------------------(cut along dotted line and return this half)

PERMISSION SLIP FOR FIELD TRIP

Childs Name________________________________________________________________
(Last)
(First)
I give permission for my child to attend with ___________________________________and
(Name of Class)
staff on a field trip to ______________________________________ on ________________.
(Location of Trip)
(Date)
I can be reached at (______)________________________ during the hours of the field trip.
(Phone)
________________________________________ ______________
signature of parent/guardian
date

Sample 5/98